cover image SEVERED TRUST: Why American Medicine Hasn't Been Fixed

SEVERED TRUST: Why American Medicine Hasn't Been Fixed

George D. Lundberg, SEVERED TRUST: Why American Medicine Hasn't Been Fixed<. , $26 (336pp) ISBN 978-0-465-04291-3

It is by now a cultural commonplace to complain about the medical profession and its lack of professionalism, its interest in profits rather than patients and the outrageous mismanagement of the health insurance industry, but this time the criticism comes from a high-profile insider. Physician and former JAMA editor Lundberg (he was fired over a Kinsey Institute study about how people define "sex" that appeared during Clinton's impeachment hearings), along with Stacey (Inside the New Temple: The High Cost of Mistaking Medicine for Religion), contends that quality patient care—the primary goal of medicine—is a casualty of the current emphasis on medicine as business. Lundberg's writing can be plodding and repetitious, but he makes a strong case. He argues for physicians' greater accountability, contending, for instance, that autopsies—no longer performed primarily because doctors fear litigation, particularly if it is determined that their diagnosis was incorrect—should become regular medical practice again, as they were just 30 years ago. Lundberg also calls for prevention of disease through standard accepted procedures such as immunization and Pap smears that would be free to patients and paid for by government revenues. Further, he proposes an "economic informed consent," in which patients and physicians "would be provided with the costs of care in advance of receiving or providing services." All in all, Lundberg presents a damning indictment of modern American medicine. (Apr.)

Forecast:Basic is backing this with a first printing of 50,000. Lundberg is a controversial and visible figure offering strong opinions on a hot topic. This call for reform should sell very well—and Lundberg will be expressing his ideas in a radio satellite tour, appealing to a large number of general readers as well as to patients' rights groups, public policy analysts and other physicians.